Entries in Painkiller
(6)

iStockphoto/Thinkstock(NEW YORK) -- Unlike championship rival Alabama, the team doctor for Notre Dame football, Dr. James Moriarity, told ABC News he does not rule out the "occasional use" of the controversial painkiller Toradol on game days to treat Fighting Irish players if "medically indicated."

By contrast, Alabama team doctor Dr. James Robinson said he has "never used it" on Crimson Tide players and will not use it during the BCS National Championship Game on Monday.

"I've actually been against it the whole time," Robinson told ABC News over the weekend in Miami, where the BCS game will be played. "It's something we've never done."

Monday's game takes place amid a growing controversy in college and professional sports over the use of painkillers on players in general, and of Toradol specifically because of the possible increased risks cited on its label of heart attack, stroke, kidney failure and internal bleeding.

Toradol was developed for use in hospitals for the short-term treatment of post-operative pain but over the last decade has found its way into team training rooms in major sports.

"It's a good pain medication," Robinson, the Alabama team doctor, said. "So post-operatively, and after an acute injury before we get them to surgery, things like that, we've used the medication... But we don't use it as a preventative medicine if you will."

Prior to the ABC News interviews with the two doctors over the weekend, college officials at Notre Dame and Alabama had refused to answer questions about whether its football players were given the powerful painkiller on game days.

An ABC News investigation found the generic version of Toradol is still being used in college and professional football programs across the country even as many team doctors have stopped using it because of concerns about the various risks.

Robinson said the use of such painkillers goes against his philosophy.

Notre Dame's Moriarity said he only administers the oral version of the painkiller and has not used Toradol injections "most of this year."

Moriarity denied the use of Toradol does not give injured Notre Dame players an edge, but said the painkiller is used on game days. "When else would you use it?" he said.

"We have used it for people in pain from certain circumstances," he said. Moriarty would not elaborate on specifics but said, "I don't think you could say it allowed them to play when they couldn't otherwise."

Moriarity said Notre Dame asks, "Are they fit to play?"

The ABC News report on Toradol focused on a former USC lineman, Armond Armstead, who claims in a lawsuit that a season-long series of Toradol injections by the team doctor resulted in a heart attack he suffered following the 2010 season.

The USC team doctor, Dr. James Tibone, told ABC News he continues to use Toradol injections on game day for injured players but said such shots did not involve any risk.

"These are healthy people," he told ABC News.

The NCAA does not regulate or keep track of the use of painkillers or Toradol, unlike professional sports leagues. NCAA officials have declined to comment on the ABC News reports.

iStockphoto/Thinkstock(NEW YORK) -- Despite stated label risks of possible fatal heart attack, stroke or organ failure, college football players across the country are still being given injections of a powerful painkiller on game days so they can play while injured, an ABC News investigation has found.

The drug, a generic version of Toradol, is recommended for the short-term treatment of post-operative pain in hospitals but has increasingly been used in college and professional sports, and its use is not monitored by the NCAA, the governing body of college sports.

Only two of the country's top football programs, Oklahoma and the University of Nebraska, reported to ABC News that they have limited or stopped the use of the drug in the wake of growing concern about its risks.

Oklahoma said it stopped using the painkillers in 2012, but records show they were used consistently in 2010 and 2011.

Nebraska said its doctors now restrict its use.

"While team physicians reserve the option to use injectable Toradol, it is rarely prescribed, and its use has been avoided this season following reports of heightened concern of potential adverse effects," Nebraska said in a statement to ABC News.

The top two college football programs, Notre Dame and Alabama, refused to answer questions from ABC News about the painkiller. They play for the national college championship on Jan. 7.

Controversy surrounding the drug has grown this year following claims by former USC lineman Armond Armstead that he suffered a heart attack after the 2010 season, at age 20, following shots of generic Toradol administered over the course of the season by the team doctor and USC personnel.

"I thought, you know, can't be me, you know? This doesn't happen to kids like me," Armstead told ABC News.

The manufacturers' warning label for generic Toradol (ketorolac tromethamine) says the drug is not intended for prolonged periods or for chronic pain and cites gastrointestinal bleeding and kidney failure as possible side effects of the drug.

In addition, like other drugs in its class, the generic Toradol label warns "may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction (heart attack), and stroke, which can be fatal."

In a lawsuit against the school and the doctor, Dr. James Tibone, Armstead claims the school ignored the stated risks of the drug and never told him about them.

"He was a race horse, a prize race horse that needed to be on that field no matter what," said Armstead's mother Christa. "Whether that was a risk to him or not."

Armstead says he and many other USC players would receive injections of what was known only as "the shot" in a specific training room before big games and again at half-time.

"No discussion, just go in. He would give the shot and I would be on my way," Armstead told ABC News.

Armstead said the shot made him feel "super human" despite severe ankle, and later shoulder pain, and that without it, he never could have played in big USC games against Notre Dame and UCLA.

"You can't feel any pain, you just feel amazing," the former star player said.

USC declined to comment on Armstead's claims, or the use of Toradol to treat Trojan players.

An ABC News crew and reporter were ordered off the practice field when they tried to question USC coach Lane Kiffin about the use of the painkiller.

Later at a news conference promoting the Sun Bowl, where USC was defeated earlier this week, Kiffin said he had no idea when or if Toradol was being used on his players, or about its risks.

"Well, if that was the case then, yeah, I did not know that until you told me," Kiffin said. "You educated me, thank you."

USC and Dr. Tibone have asked a judge to throw out Armstead's lawsuit, and in a brief interview with ABC News, Dr. Tibone denied any wrongdoing.

He said he could not comment on whether he failed to tell Armstead of the possible risks of the prescription painkiller, because of the pending lawsuit.

The team doctor did confirm to ABC News that he used Toradol to treat Armstead's pain and that he continues to use the drug on other USC players.

"These are young, healthy people," he said. "We still use it, we use it diligently."

Whatever the possible risks, an expert on medical ethics, Professor Arthur Caplan of New York University, said team doctors have an obligation to tell players.

"Even if you're the team physician, you still have to follow the standard of care and informed consent," Caplan told ABC News. "You better be disclosing all risks."

In addition to Oklahoma and Nebraska, only four of the other top college football programs questioned by ABC News said Toradol is not used by their team doctors: Ohio State, Oregon State, Boise State and Georgia.

Most schools refused to answer whether players are treated with Toradol, but four confirmed its doctors use the painkiller: Clemson, Texas A&M, San Jose State and USC.

In professional sports, the NFL, NHL and NBA allow the use of Toradol but require teams to keep close track of injections and report the information to the league.

The NCAA, the governing body of college sports, has no such requirement to regulate or even track the use of painkillers, a spokesperson told ABC News.

In a statement, the NCAA said it requires member schools to follow state and federal laws about medical treatment and prescription medicine, and publishes guidelines that include "best practices" for the handling of medication.

"NCAA members have decided that it is their individual responsibility to assure compliance with appropriate medication and treatment guidelines," said the statement.

"If we keep track of what happens to, let's say, horses in horse racing, don't we owe it to the athletes to keep track of what's going on in college sports?" asked Professor Caplan.

iStockphoto/Thinkstock(PARIS) -- The deadly venom of one of the most feared snakes in Africa apparently contains a painkiller that could rival morphine, but without the side effects, according to French scientists.

The black mamba, found throughout sub-Saharan Africa and reportedly the second-largest snake on the continent, unleashes a neurotoxic poison that attacks its victim’s nerves and shuts down major organs.

Without an antidote, a human being likely would be dead in six hours.

In a study reported in the journal Nature, researchers at the National Center for Scientific Research said they’d found mambalgins -- pain-killing proteins -- in the snake’s venom.

They’d examined 50 different species of snakes before the black mamba discovery, which has been tested on mice.

“The analgesia was as strong as morphine,” Dr. Eric Linguieglia of the Institute of Molecular and Cellular Pharmacology told the BBC, “but you don’t have most of the side effects.”

Though highly effective in eradicating pain, morphine is known to cause headaches, vomiting and other symptoms. It is also addictive.

In the mice, the black mamba’s proteins reportedly targeted pain differently than morphine, whose path through the brain can cause nausea.

Dr. Michael Roizen, an internist and anesthesiologist at the Cleveland Clinic, told ABC News that if the mambalgins were able to relieve patients of severe pain without the side effects associated with other therapies like morphine, “it would be a major advancement.”

“It’s a new avenue, a new approach to therapies,” he said Thursday. “You’d love it to work.”

He cautioned, as the study’s authors did, that the research was still in its very early stages.

iStockphoto/Thinkstock(MCLEAN, VA) -- The first-ever large-scale study to look at treatment options for prescription painkiller addiction has shown that these treatments – much like painkillers themselves – can be a double-edged sword.

The psychological effects of painkillers are one of the reasons 5.3 million American abuse them, according the National Institute on Drug Abuse. Researchers at McLean Hospital, a Harvard Medical School affiliate, conducted the first large-scale study to look at treatment options for this growing problem.

“What made this study different was the population,” said Dr. Roger Weiss, lead author and chief of the division of alcohol and drug abuse at McLean Hospital. “This is the first study that focused exclusively on people dependent on prescription opioids, not heroin.”

Tooth extractions, chronic pain, illness and other painful surgical procedures are the major reasons Americans are prescribed painkillers. These medications, branded Percocet or Vicodin, are classified as opiates, and in addition to pain relief, they can produce the same feelings of euphoria and relaxation as heroin does.

The study took 650 people addicted to prescription pain medications and treated them with buprenorphine and nalaxone. This combination, marketed together under the trade name Suboxone, safely mimics some of the effects of opioids, while reducing drug cravings, helping to control withdrawal and preventing the same “high” if patients were to abuse opioids while on Suboxone.

Half of the study participants were also given intensive individual addiction counseling. Over the 12-week trial period, 49 percent of participants had success with Suboxone in that they were able to maintain sobriety for a large portion of the study, regardless of counseling.

“This was an ideal population to treat – short history of opiate use, high employment rate and most [people] had never sought help, so they weren’t dealing with many failed attempts,” said Weiss of the success of Suboxone.

However, despite their initial improvement, when participants were weaned off Suboxone, 90 percent went back to using prescription pain medications.

Weiss and colleagues concluded that Suboxone was effective in reducing prescription drug abuse in the short-term and could be safely administered to patients in an outpatient setting with relatively short weekly medication management visits. However, the likelihood that participants would relapse on pain killers if they stopped Suboxone was extremely high.

“This study is a cautionary tale,” Weiss advised, and stressed that future studies should focus on how long people should take Suboxone to increase their chances of staying sober.

Comstock/Jupiterimages/Thinkstock(ATLANTA) -- A new report from the Centers for Disease Control and Prevention found nearly 40 Americans die per day -- about 15,000 per year -- from overdoses of painkillers such as Vicodin and OxyContin, eclipsing the number of deaths caused by heroin and cocaine combined.

"We are in the midst of an epidemic of prescription narcotic overdose," said Dr. Thomas Frieden, director of the CDC, during a telebriefing to discuss the newly published data.

The problem of abuse, officials said, is getting worse. The number of deaths represents a three-fold increase over the past decade, and CDC also found that in 2010 alone, there were enough painkillers prescribed to supply every adult with a one-month supply.

"This stems from a few irresponsible doctors rather than by drug pushers on street corners," said Frieden.

It's also an expensive problem. Agency officials put the cost of non-medical use -- misuse, for the most part -- of prescription painkillers at $72.5 billion based on government and insurance company data.

The sale of prescription painkillers and the number of related deaths vary by state, with Florida, New Mexico and Oklahoma being among the states hardest hit by the epidemic.

Back in April, the Obama administration announced a plan aimed at reducing the amount of prescription opioid abuse. One of the plan's goals is to reduce the abuse rate by 15 percent by 2015.

The plan called for the expansion of statewide prescription drug monitoring programs (PMDPs), programs that safely dispose of prescription painkillers as well as better education for patients and health care providers.

PMDPs electronically monitor painkiller prescriptions in each state. Only Missouri and New Hampshire do not have one in place. The other states and the District of Columbia are still trying to figure out how to get their programs up and running, the CDC said.

Dr. Scott Fishman, professor of anesthesiology and pain medicine at the University of California-Davis and president of the board of the American Pain Foundation, said PMDPs can be effective at curbing misuse of prescription painkillers, but they aren't completely foolproof. He also advocates educating providers and patients.

Another issue that could arise with these programs is that monitoring could be too strict, and doctors could be afraid to prescribe the medications.

Fishman added that a big part of the responsibility lies with providers who aren't properly trained.

Patients who are treated for chronic pain should also understand the addictive nature of the medications and take steps to lower the risk of getting hooked on them and keeping them out of the hands of others.

Photo Courtesy - Getty Images(OXFORD, England) - If you tell yourself your painkiller won't work, you may be tricking your brain into feeling pain, according to a new study.

The study, published in Science Translational Medicine, found that if a patient doesn't think their painkiller will be effective, it could actually become a self-fulfilling prophecy.

"It's phenomenal, it's really cool. It's one of the best analgesics we have and the brain's influence can either vastly increase its effect, or completely remove it," Professor Irene Tracey, from Oxford University, told the BBC. "Doctors need more time for consultation and to investigate the cognitive side of illness, the focus is on physiology, not the mind, which can be a real roadblock to treatment."

The study subjected 22 patients, attached to an intravenous drip, to pain by applying heat to one of their legs. Patients were then aksed to rate the pain they felt on a scale of one to 100.

Initially, patients rated the pain an average number of 66. When given a painkiller through the drip without being told, that number dropped to 55. When given the painkiller after being told, the score went down to 35. Finally, when patients were told that the painkiller was withdrawn and that they should expect pain, the average number jumped to 64, although the drug remained in their system.